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P - 48260From: 612 822 5408 b� Page: 2/2 Date: 1/25/2012 1:45:24 PM � � $uilding ��,,UMgIl�jG Inspe�cti0ns 1�SYD�+ �TI.A�� A.�"�'��C.A►�'�ON 763-572-3b04 �I7"Y Q�'+ �`i�l��'Y ?fr3-502-4977 FA� --__�_....-- - ---- S17'E ALIDRE,SS _� 'FHI$ AP?LlC.ANT ISs iiw�[ER� ��rrruv�r - sus�� co�r or• sra� �,�c�s, �''C?UR STA'� L3CENSE, HOND AND S�'ATF AOND �f �ERTIE'�GATE C!� ADEI�SS:� i1+tSLtRANCE PHONE�L?� P�RMTT TXl'� I �tNC;[.� �Anrt�tv TYPE C►�' w��: � o r�w E-MA1L ADD1tESS �UN'�'RACfOIt Z.. O TWi} FAMTf.Y �t��.acEn�s�• �,; • � • - .. . ..."" . ... Permit No.��ir� D� '' ��v� By_ � :�� -----�,- - � �!xw nn�re _!�� FI7CP EXP DaTB _�: Crf�r ,+�%rh ��.�`r> sra� _ ThX `h91r� �' � '�.�i � � , O'fnVV[�iQi1SE r��rnn�r, �a�sc��N o� wt��x ',�,��`..�..�. �,�� f,��aG�' cJ�i�,•.�,•�' r�ES nx� �.►sEn or� s� o.�a r� F�E� E?CCEPT WF�RE NO?�. rYX7 UR�Ss (iND��.1'E'TO"fa�. N�(JM�ER OF EhCH'BEW�. MtNiMUM FEE 335.50. BATH S1NKf[.AV IZOQR DitA�I3 �HUWER WtlTER PII'A'h6 `t�'rfrrtts �as r�atC (x�:�� ei•r�r cac� "sw�n�n�iTVC; �ao�. }r�-,wn'r�tt so�r►vER 1�3s) Wc�arHesw�s�x ��c�rrsrrnc —wa°rE�x�.ossr _snc�,owr�v.�a�s� _ DI5Awk5T�R _ L aUNl�HY T�t.a� �wA�^�s. [3EATett tS35) F(?R BtRIGATION � WA7'BR M1!E'F'HR _ 0'1%IER. TH[5 IS AN APPLTCATIaN POR A kExtivlT['-NOT Vpj,i]j UI�T�'�, �'�tpCE5S£D T hereby apply fqr a pjuinbing permit and T acknowlcdgc that thc information abovc is completc and aeeurate; �hat the work wili be in con�'ormance witli the ordintmc�s ttnd codrs of thc City of FridIcy and with thc Minncsota Construction Codes; tktat I understand this is tlot a permit but ot�ly an a�plicelion for e permit and work is not to start without a permit on site; that th� Work wi�1 be in accordance w�th the a�aproved plazA jn the c�st� i wh�i -�Quires rcvicw and a mY� f,Plans. % % 5[GNA"fUkE UF APPLICANT ..+��.+�' FRINT Nf1ME /9s�Lr uc �J.�.f.rr•w 1]A7E ��/ � I% _ _ __ GI� 0� �+'rlili�� tuldi�g Xn�pections Depar�tnent 5431 U�.iv�rsity Av�x�tue NE, �ridley, �VlN' S5432 763-572-3604 FA7C: 763-502-4977